A new treatment concept for bronchial stump insufficiency.

INTRODUCTION: Bronchial stump insufficiency (BSI) remains one of the most feared complications with an incidence of 0-12% in the literature. PATIENTS AND METHOD: The present retrospective study reviewed the medical records of 11 patients with BSI. Patients were divided into two groups, depending on treatment. In group A, 5 patients were treated initially unsuccessfully using other therapeutic procedures such pectoralis flap transposition, omentum majus transposition and fibrin glue applications and subsequently treated successfully with vacuum therapy (VT). In 6 patients (group B), only VT (a combination of bronchial suture, thoracoplasty, latissimus muscle transposition and VT) was performed. VT represents a closed dressing system allowing moist wound treatment in full contact with the wound surface as well as protection against contamination with nosocomial pathogens by means of continuous drainage of wound secretions. RESULTS: Of the 11 patients reviewed in this study, closure of the bronchial stump with VT was achieved in 8 patients. Of the 8 patients with successful closure of the bronchial stump, 4 patients were in group A and 4 in group B. CONCLUSION: Based on this preliminary experience, the combination of bronchial suture, thoracoplasty, latissimus muscle transposition and VT appears to be a promising concept for the management of bronchial stump insufficiency.